5 October 2021
During a routine inspection
Willow Care & Support Ltd is a domiciliary care and supported living service providing personal care for people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. There were 11 people receiving personal care at the time of the inspection.
People’s experience of using this service and what we found
The provider had not consistently maintained effective oversight of the safety and quality of the service. Risk assessments and care plans contained some errors and outdated information. Risk was somewhat mitigated due to the knowledge of small regular teams of staff that knew people well. A system was in place for staff to report accidents and incidents with an alert system set up for provider oversight.
The provider did not have a full understanding of the requirement to notify the Care Quality Commission of changes in the service.
Medicines were not consistently managed safely and required increased provider oversight to ensure information in records was current and errors or omissions were identified and actioned promptly.
People were not consistently protected from the risk of infection as staff were not being tested in line with government guidance. However, staff were trained in infection control and had access to personal protective equipment which they were using appropriately.
The provider recognised the need for the service to continuously evolve and improve and were seeking guidance and further experience and knowledge to support this process.
Staff were recruited safely and in line with current guidance. People were protected from the risk of abuse and felt safe. Staff had received training and knew how and where to report concerns.
Staff received regular supervision and were well supported by the provider. Morale in the team was good and staff were enjoying their role. Mandatory training had been provided with regular updates and specialist training was completed to meet people’s specific needs.
Care plans were written with people and their family’s involvement, they contained person-centred information for staff guidance. People told us they were leading their care, making their own decisions and their choices were respected. Care records evidenced food and hydration and personal care needs were provided as per the person’s choices.
Peoples communication needs were considered and the provider had provision to make information available in accessible formats as and when required.
People were supported to access health care and support services as and when required, a system and process was in place to support transition between services.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Care plans and care records evidenced choice and inclusion, people’s privacy and dignity was respected.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 3 August 2018 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about people’s safety. A decision was made for us to inspect and examine those risks.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified a breach of regulation in relation to the managerial oversight of the safety and quality of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.